MEDICARE: MOOSALLY MEDICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255043915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOOSALLY MEDICAL

Provider Business Mailing Address
First Line	:	8905 SOUTH ST SE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2357
Country	:	US
Telephone Number	:	330-402-3443
Fax Number	:

Provider Business Practice Location Address
First Line	:	2537 E MARKET ST
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-6257
Country	:	US
Telephone Number	:	330-460-5514
Fax Number	:	330-595-4366

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. ROBERT MOOSALLY JR.
Credential	:	DO
Telephone Number	:	330-460-5514

Provider Enumeration Date	:	12/14/2022
Last Update Date	:	12/14/2022

Similar Medicare Providers

1013993419 — MR. ROBERT T MOOSALLY DO
Practice Location Address:

2537 E MARKET ST
WARREN, OH
44483-6257

Practice Phone: 330-460-5514
Practice Fax: 330-595-4366

1316161953 — TRUMBULL FOOT HEALTH, INC.
Practice Location Address:

2537 E MARKET ST
WARREN, OH
44483-6257

Practice Phone: 330-372-5500
Practice Fax: 330-372-3536

1134087653 — SIERRA KIEFFER CT
Practice Location Address:

430 FRANKLIN ST SE
WARREN, OH
44483-5715

Practice Phone: 330-372-2200
Practice Fax:

1649631334 — KATINA ROHRMAN LPC, LSW
Practice Location Address:

318 MAHONING AVE NW
WARREN, OH
44483-4605

Practice Phone: 330-395-9563
Practice Fax: 330-393-5975

1932066511 — DARRYL LEE RODGERS SR.
Practice Location Address:

881 FAIRWAY DR NE
WARREN, OH
44483-5637

Practice Phone: 330-984-2012
Practice Fax:

1831056001 — ALLISON AUGUSTINE CT
Practice Location Address:

430 FRANKLIN ST SE
WARREN, OH
44483-5715

Practice Phone: 330-372-2220
Practice Fax: 330-372-2260

Directions to “MOOSALLY MEDICAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.